We are looking to revise the wording on our Least Incompatible form that the physician will sign when units are not compatible or not compatibility tested for transfusion (serologically). Can anyone share examples with me?

chinrich@rwjuhh.edu

-Colleen

[ATTACH=CONFIG]704[/ATTACH]We use this form for emergency/medical releases

[ATTACH]705[/ATTACH]

Here's mine.

Thanks so much. These are both great examples!

Here's what I came up with as a draft. We manage using O negs RBCs for Emergencies. I basically combined both our Emergency Release and Least Incompatible forms into 1.

[ATTACH]707[/ATTACH]

A suggestion: I would leave out this part.

The weakest of the in-vitro

incompatible units will be given to the patient.

See attachment; I think calling them least incompatible gives a false sense of security that the reaction will be less severe, which has not been proven. We just call them incompatible and let the physician decide to consider the risk of that.

Some have also called these units "serologically incompatible" which is another acceptable alternative. There is no correlation between in-vitro grading and actual in-vivo result in the patient.

Excellent information Terri, Thanks

Here's what I came up with as a draft. We manage using O negs RBCs for Emergencies. I basically combined both our Emergency Release and Least Incompatible forms into 1.

" The compatibility testing has been completed but there were serological testing problems encountered thathave not been fully identified or resolved. The medical status of the patient necessitates transfusion of theseblood products. I am aware of the risks of transfusion.

 Crossmatch compatible units are available, but all testing is not complete. "

The two statements contradict, just a heads up.

" The compatibility testing has been completed but there were serological testing problems encountered thathave not been fully identified or resolved. The medical status of the patient necessitates transfusion of theseblood products. I am aware of the risks of transfusion.



Crossmatch compatible units are available, but all testing is not complete. "

The two statements contradict, just a heads up.

What I was going for is that the crossmatch may be compatible, but antigen typing or complete rule-outs of other possible antibodies may not have been completed yet.

What I was going for is that the crossmatch may be compatible, but antigen typing or complete rule-outs of other possible antibodies may not have been completed yet.

In this situation we still classify this as incompatible since the identification is incomplete. The physician signs a release of the unit indicating that counseling of the risks involved have been explained and the responsibility and liability now lies with them.

[ATTACH]708[/ATTACH]

Ok I think I have it ready for Transfusion Committee review. Any final thoughts? I really appreciate all of your assistance. -Colleen

[ATTACH]709[/ATTACH][ATTACH]709[/ATTACH]

I'll post a form I have used that is specific for warm autos although that may not be quite what you were looking for.

Good information, Mabel. Thanks for sharing.

Mabel I really like that..Thanks

We are looking to revise the wording on our Least Incompatible form that the physician will sign when units are not compatible or not compatibility tested for transfusion (serologically). Can anyone share examples with me?

chinrich@rwjuhh.edu

-Colleen

We started ordering in the computer with DIN # as Serological Incompatible for the doctor to sign .

At our hospital we use the terminology "Best-matched" blood instead of "Least Incompatible". The doctor still has to sign and take full responsibility.

[ATTACH=CONFIG]704[/ATTACH]We use this form for emergency/medical releases

I am unable to open this attachment. Could you resend it?

Thank-you.

[ATTACH]708[/ATTACH]

Ok I think I have it ready for Transfusion Committee review. Any final thoughts? I really appreciate all of your assistance. -Colleen

I am unable to open this attachment. Could you resend it?

Thank-you

[ATTACH]705[/ATTACH]

Here's mine.

I am unable to open this attachment. Could you resend it?

Thank-you

None of the attachments can be opened. Phil please help?

I am unable to open this attachment. Could you resend it?

Thank-you

Emergency Release Form.doc

These attachments can't be opened.

I can open them . . . maybe your IT dept has a block on such stuff. 

I can't open any but Terri's recent repost.  I am on my home computer so can't blame IT this time.  I am using Chrome as my browser but that has never been a problem here before.

[ATTACH]707[/ATTACH]

A suggestion: I would leave out this part.

The weakest of the in-vitro

incompatible units will be given to the patient.

See attachment; I think calling them least incompatible gives a false sense of security that the reaction will be less severe, which has not been proven. We just call them incompatible and let the physician decide to consider the risk of that.

Some have also called these units "serologically incompatible" which is another acceptable alternative. There is no correlation between in-vitro grading and actual in-vivo result in the patient.

 

EXACTLY!  We shouldn't be talking 'least incompatible' anymore and we need to teach our MDs to stop talking that way, too. 

 

BTW:  Since it is under the BB MD license to choose blood for patients, we do not put this burden on the ordering MD who is likely not well versed in all these BB variables.  

 

We have written protocol regarding how to deal with warm/cold panagglutinins which I won't go into on this string. But, I will say if we have to give out RBCs that are truly incompatible, it is because we are not given the time to find antigen-negative RBCs or to complete our investigative testing.  If this happens, the MD is required to sign for 'Emergency Release'.